In the event of an aortic valve stenosis or insufficiency, a surgical procedure is indicated in many cases, in which the body's own aortic valve is replaced by an artificial aortic valve. Apart from the open surgical operation which is carried out under general anesthetic and by use of a heart-lung apparatus and in which the sternum is opened up using a saw, the heart is exposed and has to be stopped, the aortic valve can also be replaced in a minimally invasive procedure on the beating heart. In doing so, an access route via the femoral artery (transfemoral) or via the cardiac apex (transapical) is selected.
One possible way is the introduction of an aortic valve prosthesis which expands by itself or is expanded by means of a balloon and displaces the body's own aortic valve. However, the bloodstream may be impaired by undefined lateral openings which are generated between the artificial aortic valve and the aortic wall if the natural aortic valve is not removed but crushed against the aortic wall by the artificial aortic valve.
In this regard, it is recommended to first remove the body's own aortic valve prior to inserting the artificial aortic valve.
Regarding the aortic valve resection, many solutions are known in which the calcified aortic valve is cut out with a laser. There are also publications, however, according to which the calcified aortic valve (in the laboratory and on a pig) has been removed by an “aorta punching device”.
The process of separating the calcified aortic valve with laser technology is very time-consuming and not very precise, too. The removal of a valve with an “aorta punching device” is not feasible at present, as the rigid punching head already matched with the inner diameter of the aorta has to be passed through the constricted aortic valve and chalky particles deposited on the aortic valve may come loose and find their way into the blood circulation, which might result in a thrombosis. Here, a further problem is the fact that the aortic diameters vary in the range between approximately 15 mm and 35 mm, so that a rigid punch head does not have the optimum diameter in the majority of cases, which in turn has the consequence that the provided aortic valve inserted therein does not have the optimum fit.